Recently, a news about an Internet platform giving moon cakes to users, but causing diarrhea to many people, has caused heated discussions on the Internet. It turned out that sugar alcohol completely replaced sucrose in the moon cake recipe, and excessive sugar alcohol content is very likely to cause diarrhea.
Feng Kaili, a doctoral student in epidemiology and health statistics at Peking Union Medical College, was a witness to the incident. On September 11, in an interview with a reporter from Science and Technology Daily, Feng Kaili said: "Although such food has no hygienic problems, it will also cause adverse reactions to consumers."
Sugar alcohols are the most common nutritional sugar substitutes, but excessive consumption may cause diarrhea. Taking this incident as an example, the supplier replaced all the sugar, which originally accounted for about 20% of the total weight of the moon cake, with sugar alcohol, which was the cause of diarrhea among consumers.
Feng Kaili explained that after sugar alcohol enters the large intestine, due to poor absorption, it will stay in the intestinal lumen, and then ferment to produce gas on the one hand, and on the other hand, they will also increase the osmotic pressure in the intestinal tract, so that the water in the intestinal cells is absorbed. The concentration gradient formed by the external osmotic pressure "sucks" out. This excess water can cause loose stools and diarrhea.
It is worth noting that secretory diarrhea caused by common bacteria, viruses and other infections in daily life is different from osmotic diarrhea caused by excessive consumption of sugar alcohols. The symptoms of "tenesmus" in secretory diarrhea are rare in osmotic diarrhea. To deal with osmotic diarrhea caused by sugar alcohol, as long as you fast and wait for the sugar alcohol to be completely excreted, the symptoms of diarrhea will completely disappear, and diarrhea caused by infection, fasting is useless. In addition to diarrhea, common symptoms of intolerance caused by sugar alcohols include increased gas and bloating.
Feng Kaili reminded that people with weak digestive function or intestinal diseases, such as patients with irritable bowel syndrome, need to eat as little sugar alcohol as possible.
Since sugar alcohols are not an essential nutrient, there is no “recommended intake” for sugar alcohols. There are great differences in the tolerance of sugar alcohols between individuals, and the relevant limits of sugar alcohols have not been specified in my country's national standard for food additives GB 2760-2014. Judging from the latest research results, sorbitol, xylitol, and maltitol may cause diarrhea if adults consume more than ten grams at a time, while the erythritol used in many beverages generally consumes fifty or sixty grams will cause diarrhea.
How to reduce the risk of diarrhea caused by sugar alcohols? Feng Kaili suggested that adding sugar alcohols to a complete meal, instead of eating foods containing only sugar alcohols, can improve absorption. Foods rich in FODMAPs (such as lactose-rich milk, sorbitol-rich prunes) and some foods rich in dietary fiber (such as oats, whole-wheat bread with a high content of whole-wheat flour, etc.) It is difficult to digest by itself, and it is even less suitable for consumption with sugar alcohols.